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temporomandibular joint syndrome

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Temporomandibular joint  (TMJ)

Alternative Names
TMJ syndrome, TMJ, temporomandibular dysfunction syndrome, myofascial pain dysfunction syndrome, Costen's syndrome

Temporomandibular joint syndrome or TMJ affects the joint that connects the jawbone to the skull.

What is going on in the body?
TMJ is a poorly understood disorder. It is thought to be due to a disturbance of the joint that connects the back of the jaw to the skull. This joint is located just in front of the ear and can be felt when the jaw opens and closes.

What are the signs and symptoms of the condition?
TMJ may cause a wide variety of complaints, including:
  • jaw and ear pain
  • hearing difficulty
  • a stuffy sensation in the ears
  • a clicking or snapping noise heard in the joint when the jaw is opened and closed
  • headaches
  • limited ability to open the mouth
  • pain behind the eye
  • spasm or pain in the muscles used for chewing
What are the causes and risks of the condition?
The exact cause of TMJ is still a subject of debate. This condition is more common in women and often occurs in people who are 20 to 40 years old. The following are thought to be partly responsible in many cases of TMJ:
  • poor alignment of the jaw or teeth
  • stress
  • clenching or grinding of the teeth
  • overuse or trauma to the muscles used in chewing
  • abnormal structure of the joint
  • abnormal sensitivity to pain in the area of the joint or muscles used for chewing
The primary risks of TMJ are related to the discomfort symptoms can cause. When the condition flares up, a person may temporarily be unable to move his or her jaw.

What can be done to prevent the condition?
Braces and other dental appliances to correct poor alignment of the jaw and teeth may prevent or correct some cases. People should avoid grinding their teeth and clenching their jaws. Because the cause is poorly understood, prevention is usually difficult.

How is the condition diagnosed?
The history and physical examination often make a doctor suspect this condition. Blood tests and X-rays are often used to make sure more serious diseases are not causing the symptoms. No single test can confirm the diagnosis. Dental X-rays can sometimes help make the diagnosis.

What are the long-term effects of the condition?
Prolonged TMJ may result in deformity of the joint or poor alignment of the jaw or teeth. The main long-term effect is frustration from the symptoms. For many people with TMJ, there are no long-term effects.

What are the risks to others?
There are no risks to others. This condition is not contagious.

What are the treatments for the condition?
Initial treatment involves identifying actions that cause symptoms to get worse, such as clenching or grinding the teeth. Many people may not realise they are doing these things. Medications for pain and muscle spasm are also used.

If these treatments fail, referral to a dentist who treats TMJ may be needed. Special bite appliances may be used. Physiotherapy and relaxation therapy may also help. In severe cases of TMJ that do not respond to other treatments, surgery to realign the jaw is sometimes helpful.

What are the side effects of the treatments?
All medications have possible side effects. Pain relievers may cause stomach upset and allergic reactions. Muscle relaxants may make people sleepy. Other side effects depend on the drug used. Surgery may cause bleeding or infection and does not always cure TMJ.

What happens after treatment for the condition?
If symptoms go away, no further treatment is generally required.

How is the condition monitored?
Symptoms and a physical examination are primarily used to monitor TMJ. X-rays may be used in some cases for monitoring.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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